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Biomedical subjects

S B Gandham

Publications and source records attributed to S B Gandham.

6 recordsLinked to original sources

Autologous patch graft in tube shunt surgery.

PURPOSE: To evaluate an alternate method of covering the subconjunctival portion of the tube in aqueous shunt surgery. Evidence of tube erosion, graft-related infection, graft melting, or other associated intraocular complications were evaluated. METHODS: A retrospective study of 16 patients (17 eyes) who underwent tube shunt surgery at Wills Eye Hospital between July 1991 and October 1996 was conducted. An autologous either "free" or "rotating" scleral lamellar graft was created to cover the subconjunctival portion of the tube shunt. RESULTS: All patients were evaluated for at least 6 months, with a mean follow-up of 14.8 months (range 6-62 months). All eyes tolerated the autologous graft well, with no clinical evidence of tube erosion, or graft-related or intraocular complications. CONCLUSION: Autologous patch graft in tube shunt surgery appears--in selected cases--to be an effective, safe and inexpensive surgical alternative to allogenic graft materials. It also offers ease of availability, and eliminates the risk of transmitting infectious disease.

Adult↗

Neodymium: YAG membranectomy for pupillary membranes on posterior chamber intraocular lenses.

PURPOSE: To evaluate the effectiveness of neodymium: YAG laser for the removal of membranes from the anterior surface of intraocular lenses. METHODS: Seven patients had reduced vision due to a membrane on the anterior surface of a posterior chamber intraocular lens (PC IOL). Six of the membranes developed after extracapsular cataract surgery and PC IOL combined with trabeculectomy and one after pars plana vitrectomy. Six of the membranes developed in the early postoperative period in association with a fibrinous reaction of the anterior chamber. One formed 7 months after surgery in an eye with iris capture behind the IOL. The membranes persisted despite intensive topical steroid therapy. A neodymium: YAG (Nd:YAG) laser was used to remove the membranes from the anterior of the IOL in all the seven cases. RESULTS: The Nd:YAG laser effectively severed the peripheral connections of the membranes to the iris and lens, creating a clear central zone within the visual axis. The settings were fundamental mode, 1.2-to 3.1-mJ energy per shot and 48.3 +/- 20.1 single pulses. Vision improved significantly in six patients, whereas elevated intraocular pressure was observed in one patient. CONCLUSION: Postoperative pupillary membranes may be successfully lysed with use of the Nd:YAG laser.

Aged↗

Aqueous tube-shunt implantation and pars plana vitrectomy in eyes with refractory glaucoma.

We reviewed the surgical outcome of 20 eyes of 20 consecutive patients who had undergone combined aqueous tube-shunt implantation and vitrectomy for complicated glaucoma associated with vitreoretinal disorders. After a mean follow-up of 10.39 +/- 5.43 months, visual acuity remained stable or improved in 13 patients (65%), and intraocular pressure was controlled (< 22 mm Hg) in 15 (75%). The most common complications were corneal edema (seven eyes) and choroidal effusion (three eyes). Combined tube-shunt implantation and pars plana vitrectomy may successfully control intraocular pressure and maintain preoperative visual acuity in refractory glaucoma associated with vitreoretinal disorders.

Adolescent↗

Methazolamide-induced skin eruptions.

To our knowledge, this is the first histopathologic report of skin eruptions due to oral methazolamide. From the four cases studied, we conclude that there are at least two histopathologic types: one is characterized by perivascular lymphocytic infiltrate with a vacuolar alteration at the dermoepidermal junction, the other by perivascular eosinophils, lymphocytes, and scattered mast cells. There also seem to be at least two patterns of skin eruptions: one maculopapular and the other urticarial. The type of skin eruption and the histopathologic type appear to be related.

Administration, Oral↗

New topical medications in the treatment of glaucoma.

1. Latanoprost is not preferred for use in inflammatory glaucoma. 2. Brimonidine acts by reducing the aqueous inflow and promotes uveoscleral outflow. 3. Dorzolamide causes a moderate reduction of intraocular pressure, but is relatively safe.

Administration, Topical↗